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CPT code 78258: Esophageal motility, radionuclide transit study2026 Medicare rate & RVUs in North Carolina

Reports radionuclide assessment of esophageal transit when a clinician evaluates impaired esophageal movement, such as in a patient with dysphagia.

CMS RVU26DEffective Oct 1, 2026One payment locality85 Medicare services in 2024

In North Carolina, Medicare pays $192.48 for 78258 in the office.

$192.48Office (non-facility)
Not available in this settingHospital or facility
−6.3%vs the national office rate ($205.42)

Check a contract rate as a % of Medicare · 78258 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 78258 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in North Carolina
  2. What 78258 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 78258 covers

This nuclear medicine study evaluates how material moves through the esophagus. The patient swallows a radiotracer-containing bolus while a gamma camera records its passage; the resulting images help assess esophageal transit in a patient with symptoms such as dysphagia or suspected motility impairment. Nuclear medicine staff typically perform the imaging, and a physician interprets the findings. It is distinct from pressure-based esophageal manometry.

Report the study when the record supports a radionuclide evaluation of esophageal movement, rather than a reflux or gastric-emptying assessment. Documentation should identify the clinical reason, the imaging performed, and the physician’s interpretation. CMS recognizes a professional component for interpretation, reported with modifier 26, and a technical component for equipment and staff, reported with modifier TC. Reporting without either modifier represents the global service.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How North Carolina compares for 78258

Across 109 of 109 payment localities, the office rate for 78258 runs from $178.92 in Arkansas to $285.80 in San Benito County, CA. North Carolina pays $192.48. The RVUs are the same everywhere; the geographic indexes change the dollars.

78258 in North Carolina vs other payment areas
  1. North Carolina · this page$192.48
  2. Los Angeles, CA · California$238.20+$45.72
  3. Washington, DC area · District of Columbia$238.82+$46.34
  4. Miami, FL · Florida$216.83+$24.35
  5. Chicago, IL · Illinois$209.94+$17.46
  6. Manhattan, NY · New York$237.47+$44.99
  7. Alaska · Alaska$227.86+$35.38

Other areas in North Carolina first, then benchmark localities. Bars start at $0.

Every other payment area

78258 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$181.92—
ArkansasArkansas$178.92—
ArizonaArizona$199.49—
Bakersfield, CACalifornia$221.98—
Chico, CACalifornia$221.74—
El Centro, CACalifornia$221.75—
Fresno, CACalifornia$221.74—
Hanford, CACalifornia$221.74—

78258 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$178.92

$253.77

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
78258 office rate range by state
State / territoryOffice rate rangeLocalities
AK$227.861
AL$181.921
AR$178.921
AZ$199.491
CA$221.74–$285.8029
CO$216.561
CT$220.221
DC$238.821
DE$203.121
FL$198.90–$216.833
GA$186.63–$208.882
GU$228.771
HI$228.771
IA$188.621
ID$189.711
IL$191.37–$212.474
IN$191.001
KS$186.941
KY$185.351
LA$184.75–$195.242
MA$214.73–$240.772
MD$207.58–$238.823
ME$190.11–$202.822
MI$190.21–$200.992
MN$208.721
MO$180.69–$196.843
MS$179.881
MT$205.411
NC$192.481
ND$203.831
NE$189.991
NH$212.411
NJ$223.08–$235.702
NM$191.121
NV$205.151
NY$195.69–$243.025
OH$189.891
OK$185.701
OR$203.91–$224.952
PA$190.62–$213.692
PR$207.341
RI$211.481
SC$191.431
SD$203.641
TN$187.921
TX$189.14–$215.528
UT$194.421
VA$201.59–$238.822
VI$207.341
VT$202.311
WA$214.56–$246.692
WI$196.061
WV$183.161
WY$204.721

See 78258 in every payment locality

How the 78258 rate is calculated

Each of 78258’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 78258

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.72

0.72 RVUs× 1.000 GPCI

Practice expense5.35

5.35 RVUs× 1.000 GPCI

Malpractice0.08

0.08 RVUs× 1.000 GPCI

Adjusted RVUs

6.1500

Conversion factor

$33.4009

Medicare rate

$205.42

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact North Carolina inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

9,284

Code
78258
Physician work
0.72
Practice expense
5.35
Malpractice
0.08

GPCI2026.csv

83

Locality
North Carolina
Physician work
1.000
Practice expense
0.933
Malpractice
0.639
Office calculation for 78258 in North Carolina
ComponentRVULocality factorAdjusted
Physician work0.72× 1.0000.7200
Practice expense5.35× 0.9334.9916
Malpractice0.08× 0.6390.0511
Total RVUs5.7627
Conversion factor× 33.4009

Office rate, North Carolina$192.48

Office: (0.72 × 1 + 5.35 × 0.933 + 0.08 × 0.639) × $33.4009 = $192.48

Open 78258 in the RVU calculator

Payment rules and modifiers for 78258

The CMS indicators that decide how 78258 is paid alongside other services.

CMS payment indicators · 78258

Esophageal motility, radionuclide transit study

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical1Diagnostic test with separate professional (26) and technical (TC) components.

What modifiers do to the payment

Modifier 26 · payment effect

With and without the modifier

78258 without 26 · national office

$205.42

Esophageal motility, radionuclide transit study

78258-26 · Professional component

$33.73

Pays only the interpretation and report.

When to use modifier 26

Codes related to 78258

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 78258
CodeHow it relatesOffice range, North Carolina
Used instead
78262Reflux imaging, gastroesophageal refluxRadionuclide study focused on gastroesophageal reflux rather than esophageal transit.$203.56
91010Esophageal manometry, standard pressure studyPressure-based esophageal manometry evaluates motility by a different method.$231.27
78299GI nuclear medicine, unlisted procedureUnlisted GI nuclear medicine procedure code when no listed code describes the service.No office rate

How 78258 has changed in North Carolina

78258 · Office / nonfacility

$192.48

Effective 2026-10-01

The base rate is $14.88 higher than on 2025-10-01, moving from $177.60 to $192.48 (8.4%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $177.60changed to$192.48

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.74 changed to 0.72
    • Practice expense RVU 5.08 changed to 5.35
    • Malpractice RVU 0.07 changed to 0.08
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.665 changed to 0.639

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $184.00changed to$177.60

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 5.12 changed to 5.08

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $181.00changed to$184.00

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $190.12changed to$181.00

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 5.19 changed to 5.12
    • Malpractice RVU 0.08 changed to 0.07
    • Practice expense GPCI 0.927 changed to 0.926
    • Malpractice GPCI 0.742 changed to 0.665

  5. January 1, 2023

    RVU23A

    $196.23changed to$190.12

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.26 changed to 5.19
    • Malpractice RVU 0.06 changed to 0.08
    • Practice expense GPCI 0.928 changed to 0.927
    • Malpractice GPCI 0.819 changed to 0.742

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $204.98changed to$196.23

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 5.48 changed to 5.26

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $209.19changed to$204.98

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.38 changed to 5.48
    • Malpractice RVU 0.07 changed to 0.06
    • Practice expense GPCI 0.930 changed to 0.928
    • Malpractice GPCI 0.757 changed to 0.819

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $212.96changed to$209.19

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 5.50 changed to 5.38
    • Practice expense GPCI 0.931 changed to 0.930
    • Malpractice GPCI 0.695 changed to 0.757

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $222.11changed to$212.96

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 5.78 changed to 5.50

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $221.19changed to$222.11

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 5.77 changed to 5.78
    • Malpractice GPCI 0.732 changed to 0.695

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $216.55changed to$221.19

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 5.65 changed to 5.77
    • Practice expense GPCI 0.930 changed to 0.931
    • Malpractice GPCI 0.768 changed to 0.732

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $214.84changed to$216.55

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 5.60 changed to 5.65
    • Malpractice RVU 0.04 changed to 0.07

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $213.77changed to$214.84

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $211.12changed to$213.77

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 5.50 changed to 5.60
    • Malpractice RVU 0.06 changed to 0.04
    • Practice expense GPCI 0.929 changed to 0.930
    • Malpractice GPCI 0.732 changed to 0.768

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $215.52changed to$211.12

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 5.99 changed to 5.50
    • Practice expense GPCI 0.927 changed to 0.929
    • Malpractice GPCI 0.695 changed to 0.732

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $215.52

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$192.48Not available in this settingRVU26D
2026-07-01$192.48Not available in this settingRVU26C
2026-04-01$192.48Not available in this settingRVU26B
2026-01-01$192.48Not available in this settingRVU26A
2025-10-01$177.60Not available in this settingRVU25D
2025-07-01$177.60Not available in this settingRVU25C
2025-04-01$177.60Not available in this settingRVU25B
2025-01-01$177.60Not available in this settingRVU25A
2024-10-01$184.00Not available in this settingRVU24D
2024-07-01$184.00Not available in this settingRVU24C
2024-04-01$184.00Not available in this settingRVU24B
2024-03-09$184.00Not available in this settingRVU24AR
2024-01-01$181.00Not available in this settingRVU24A
2023-10-01$190.12Not available in this settingRVU23D
2023-07-01$190.12Not available in this settingRVU23C
2023-04-01$190.12Not available in this settingRVU23B
2023-01-01$190.12Not available in this settingRVU23A
2022-10-01$196.23Not available in this settingRVU22D
2022-07-01$196.23Not available in this settingRVU22C
2022-04-01$196.23Not available in this settingRVU22B
2022-01-01$196.23Not available in this settingRVU22A
2021-10-01$204.98Not available in this settingRVU21D
2021-07-01$204.98Not available in this settingRVU21C
2021-04-01$204.98Not available in this settingRVU21B
2021-01-01$204.98Not available in this settingRVU21A
2020-10-01$209.19Not available in this settingRVU20D
2020-07-01$209.19Not available in this settingRVU20C
2020-04-01$209.19Not available in this settingRVU20B
2020-01-01$209.19Not available in this settingRVU20A
2019-10-01$212.96Not available in this settingRVU19D
2019-07-01$212.96Not available in this settingRVU19C
2019-04-01$212.96Not available in this settingRVU19B
2019-01-01$212.96Not available in this settingRVU19A
2018-10-01$222.11Not available in this settingRVU18D
2018-07-01$222.11Not available in this settingRVU18C
2018-04-01$222.11Not available in this settingRVU18B
2018-01-01$222.11Not available in this settingRVU18AR1
2017-10-01$221.19Not available in this settingRVU17D
2017-07-01$221.19Not available in this settingRVU17C
2017-04-01$221.19Not available in this settingRVU17B
2017-01-01$221.19Not available in this settingRVU17A
2016-10-01$216.55Not available in this settingRVU16D
2016-07-01$216.55Not available in this settingRVU16C
2016-04-01$216.55Not available in this settingRVU16B
2016-01-01$216.55Not available in this settingRVU16A
2015-10-01$214.84Not available in this settingRVU15D
2015-07-01$214.84Not available in this settingRVU15C
2015-04-01$213.77Not available in this settingRVU15B
2015-01-01$213.77Not available in this settingRVU15A
2014-10-01$211.12Not available in this settingRVU14D
2014-07-01$211.12Not available in this settingRVU14C
2014-04-01$211.12Not available in this settingRVU14B
2014-01-01$211.12Not available in this settingRVU14A
2013-10-01$215.52Not available in this settingRVU13D
2013-07-01$215.52Not available in this settingRVU13C
2013-04-01$215.52Not available in this settingRVU13B
2013-01-01$215.52Not available in this settingRVU13AR

Price 78258 for an earlier date of service

Where the North Carolina rate applies

North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Advance
  • Ahoskie
  • Alamance
  • Albemarle
  • Alexis
  • Alliance
  • Altamahaw

Browse all communities in North Carolina

78258 billing questions

How is this different from esophageal manometry?

This code represents radionuclide imaging of esophageal transit. Manometry, reported with 91010, measures pressure and coordination using a catheter rather than imaging a swallowed tracer.

When should 78262 be considered instead?

Use 78262 for a radionuclide study focused on gastroesophageal reflux. Use 78258 when the clinical question is esophageal movement or transit.

Can the professional and technical portions be billed separately?

Yes. Report modifier 26 for the physician’s interpretation or modifier TC for the equipment and staff portion. Without either modifier, the claim represents the global service.

What documentation supports reporting 78258?

The record should support a radionuclide esophageal transit evaluation and include the clinical indication, imaging performed, and interpretation. Dysphagia or suspected impaired esophageal movement may support the study when documented.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 78258PPRRVU2026_Oct_nonQPP.csv, line 9,284 (RVU26D)
Geographic factors for North CarolinaGPCI2026.csv, line 83 (RVU26D)

Open CMS sourceHow we calculate rates

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